Primary Care

Physicians writing on KevinMD about the primary care shortage, the fifteen-minute visit, panel size, what primary care is paid against procedural specialties, continuity, and the administrative load that has grown around the work. Four maintained records draw on this archive: Primary care: what physicians say, in their own words, Direct primary care: what physicians say, in their own words, Prior authorization: what physicians say, in their own words, and Scope of practice: what physicians, nurse practitioners, and PAs say, in their own words.

National Influenza Vaccination Week: Time to take stock of our influenza vaccination efforts

Kevin

Conditions and Diseases

January 11, 2010

The following is part of a series of original guest columns by the American Medical Association.

by Nancy H. Nielsen, MD

Back in September, I wrote in this space about ways physicians can prepare their practices to handle this challenging flu season and mentioned the importance of vaccination for all health care professionals. Today as National Influenza Vaccination Week begins, this is an excellent opportunity to remind ourselves, …

Op-ed: Ways to make primary care the key to health reform

Kevin

Health Policy

January 9, 2010

The following op-ed, co-written with Rahul Parikh, was published on December 16th, 2009 in CNN.com.

America is closer to meaningful health care reform than at any time in its history. As we have all witnessed, finding a way to both provide every American access to affordable health care while seeking to control health care costs has not been easy.

Many of the proposed solutions have led to sharp disagreements, with contention …

How a psychiatrist can write 100,000 prescriptions a year, and what that means for primary care

Matthew Mintz, MD

Physician

January 8, 2010

The Miami Herald is reporting an investigation of a psychiatrist who wrote almost 100,000 prescriptions a year. Sen. Grassley and the feds have halted payment to this Miami psychiatrist who stated that “he prescribes only what is medically necessary” and “works long hours, seeing patients for 10 minutes at a time and many of his patients need four or five medications.”

I have no personal knowledge, interaction, acquaintance with psychiatrist Dr. …

Doctors owe their patients some fiduciary responsibility

Kevin

Physician

January 7, 2010

Originally published in HCPLive.com

by Jeff Brown, MD

Fiduciary responsibility is the obligation for people entrusted with financial affairs to act in their client’s best interest, theoretically being both transparent in their dealings and accountable for them. Typically, this applies to CPAs, lawyers, financial advisers and the like. Would that it were also true for our legislators, but that’s a story for another day. To the point, physicians do not usually think …

Public hospitals are the unsung jewels of our healthcare system

Danielle Ofri, MD, PhD

Physician

January 5, 2010

Public hospitals have a bad rap. They’re viewed by many as hospitals of last resort, and most patients with private insurance do anything to avoid them.

As a long-time physician in a public hospital, I’m sensitive to this reputation. I wouldn’t work in my hospital if I didn’t feel that it delivered excellent health care. I’m certainly aware that private hospitals have amenities that public hospitals can’t afford, but many of …

How women can benefit from oral contraceptive pills

Kevin

Medications

December 31, 2009

Originally posted in MedPage Today

by Nancy Walsh, MedPage Today Contributing Writer

Hormonal contraceptives have a variety of noncontraceptive uses, ranging from common problems such as dysmenorrhea to severe conditions such as premenstrual dysphoric disorder, according to a new practice bulletin from the American College of Obstetricians and Gynecologists (ACOG).

“Combined hormonal contraceptives can correct menstrual irregularities resulting from oligo-ovulation or anovulation and …

How to tell a family that their loved one has died

Kevin

Patient

December 30, 2009

by Tim Noonan

When a team misses out on an opportunity to go to the Super Bowl, World Series, Final Four, or something similarly trivial, these words may be appropriate. When the person, who has been the center of your life dies, what is more insensitive than, We’re sorry for your loss?

What kind of language is that to use when providing some of the worst news we could imagine? True, we …

Why are women refusing an MRI to screen for breast cancer?

Kevin

Conditions and Diseases

December 30, 2009

Originally published in MedPage Today

by Crystal Phend, MedPage Today Senior Staff Writer

Many women at elevated breast cancer risk may refuse MRI as part of their screening program, largely because of fear and inconvenience, researchers found.

Among eligible women with dense breasts who were at intermediate to high risk for breast cancer, 42.1% refused additional MRI screening as part of a …

Smoking related diseases are the number one cause of death in African-Americans

Erin Marcus, MD

Conditions and Diseases

December 28, 2009

Lawrence Jones started smoking Kool Menthols when he was playing Rhythm and Blues in the ‘70s, as a way of fitting in with his bandmates and the in crowd at the clubs where he played.

The band broke up after a few years, but the cigarettes remained. Instead of being a way to look sophisticated, smoking became a means for Jones to relax and, he says, to feel he was “in …

How constant H1N1 breaking news updates may be going too far

Jeffrey Hall Dobken, MD, MPH

Conditions and Diseases

December 23, 2009

Originally posted in MedPage Today

She is 11, a fifth grader, as prepubescent as nature allows, and utterly terrified.

She hasn’t eaten normally for nearly a month, her mother reports. She sleeps poorly, reports nightmares, and cleans her hands so obsessively that she is literally bleeding raw.

Her fifth grade peer group typically does not guard its language nor govern its remarks, …

How doctors can afford to have a vacation

Kevin

Physician

December 22, 2009

Originally published in HCPLive.com

by Jeff Brown, MD

Now this is a fun topic. I’ve always liked writing, “For a vacation” on a script pad for those stressed out patients who need to go on one. Even a weekend away, or in this economy, a “staycation.” It’s good for the soul. And it’s a good use of medical authority to help your patients.

…

Is the end of pandemic H1N1 flu near?

Kevin

Conditions and Diseases

December 20, 2009

Originally posted in MedPage Today

by Crystal Phend, MedPage Today Senior Staff Writer

The end of the so-called second wave of pandemic H1N1 influenza may be in sight as testing rates — and the number of positive tests for the virus — show evidence of decline across the country, a report affirmed.

From their peak in late October, diagnostic H1N1 testing rates …

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Is the end of pandemic H1N1 flu near?

The medical home in health reform’s attempt to fix primary care

Kevin

Health Policy

December 19, 2009

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Encouraging “medical homes” to deliver care outside the emergency room should be a key aspect of healthcare reform, according to researchers, policymakers, and business leaders.

“It’s not rocket science to put a nurse practitioner near a public housing project,” said Jeffrey Brenner, MD, a physician in private practice in Camden, …

How doctors can show respect to patients

Danielle Ofri, MD, PhD

Patient

December 18, 2009

“Angelina Gomez,” the medical assistant hollers out to the crowded waiting room. As always, I cringe when I hear this. It sounds so harsh, so cattle-like. I know that the assistant is actually a gentle and caring person, and I understand that he uses a loud voice so that he can be heard over the general din of a large waiting room.

Nevertheless it feels horrible to me, so demeaning, like …

Best ways to get more patients for your medical practice

Kevin

Physician

December 18, 2009

Originally published in HCPLive.com

by Ed Rabinowitz

Pump up the volume. That’s what physician practices would like to do, and it has nothing to do with louder music. An increase in patient volume is the goal of virtually every practice. Even though the economy is struggling, there are still things physicians can do to increase the foot traffic passing through the practice’s corridors. And according to Drew Stevens, PhD, a practice management …

How can quitting smoking improve lung function in patients with asthma?

Kevin

Conditions and Diseases

December 18, 2009

Originally published in MedPage Today

by Chris Emery, MedPage Today Contributing Writer

Asthmatic smokers who quit the habit can reverse lung damage that exacerbates their breathing difficulties, regardless of how long and how often they smoked in the past, a Dutch study found.

The lungs of asthmatics who stopped smoking were in similar condition to those of asthmatics who never smoked, based …

What women should know about the new mammogram guidelines

Erin Marcus, MD

Conditions and Diseases

December 17, 2009

Whenever I order a mammogram for a woman in her 40’s, I also give her a warning: “Don’t get scared if it’s abnormal.” I tell her this because research shows that a woman who undergoes 10 routine screening mammograms has a 50-50 chance of having something unusual that requires her to go for more tests. The vast majority of these mammographic abnormalities aren’t cancer, but she still needs to get …

How an iPod Touch can make you a better doctor

Iltifat Husain, MD

Physician

December 17, 2009

There has been a great deal of commentary profiling medical applications that are useful for healthcare providers. However, there hasn’t been much talk about how mobile medical applications can enhance the doctor-patient experience and in turn help optimize your practice’s overall experience. In future posts, we’ll focus more on applications for medical providers, but this post will discuss applications centered around the physician-patient relationship.

12 most important medical advances of the decade

Dr. Charles

Physician

December 16, 2009

As the first decade of the 21st century comes to an end, it is interesting to look back and reflect on the most significant medical advances we’ve seen. I’d like to present 12 medical advances that I consider to have been the most important over the past decade, and I’d like to ask you, the wider world, to contribute in two ways:

– Add your nomination in the comment field regarding …

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12 most important medical advances of the decade

The limits of using Medicare patient data for quality outcomes

Kevin

Health Policy

December 16, 2009

Originally published in MedPage Today

by Todd Neale, MedPage Today Staff Writer

Most primary care physicians don’t see enough Medicare patients to determine statistically significant differences in cost and performance between practices, researchers found.

In fact, nearly two-thirds (65.7%) of primary care doctors worked in practices that saw too few Medicare patients to provide reliable comparisons with national benchmarks for cost and …

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